Laparoscopic Appendectomy in a 23 week Primigravida

This is the first of its kind procedure at PIMS,Islamabad,Pakistan.Laparoscopic appendectomy was carried out in a23 weeks primigravida with two days history of right upper abdominal pain with 12000 TLC.ultrasound did,nt pick any other pathology.Endo GIA universal stappler was used to amputate the appendix.Postoperative recovery was excellent without any complications & fetal distress

Category:

Education

Tags:

• PIMS
• aatifinam
• Laparoscopic
• appendectomy
• Primigravida
• MIS

[aatifinam]

Appendix along with Cecum is displaced by enlarged uterus superiorly and laterally from right iliac fossa to right hypochondrium during pregnancy.If you keep this in mind then it is not that difficult to locate appendix.

[aatifinam]

Yes this is not a new surgery for the world but where i practice i was the first one to do it .The reason is multifactorial n mainly economics.

I faced great resistance from many of mycolleagues as they thought laparoscopy is absolutely contraindicated in pregnancy.

I do not use stappler routinely or that matter ultrasonic dissector .I used endo GIA stappler as the patient was a colleague as well .i have used endoloops,intra n extra corporeal suturing ,even liga clips for lap appendectomy.

[iluvamedic]

I think that is amazing. I do have some anatomy related questions if you do not mind. Being the fact that the patient was in her second trimester, how much more difficult would you say it is to locate the appendix due to the anatomical changes from the enlarged uterus?

Surgical Technology student

[sbcontro]

I think this is not a extra new surgery.Why r u using stappler instead of endo/extracorporeal knot now-a-days?..Dr. Susanta Behera,MS Consultant:Gen.& Lap. Surgeon,Orissa,India.